Knowledge attitude and practice regarding cervical cancer screening among pregnant women attending antenatal clinic in Saint Paul’s hospital Millennium medical college
Abstract
Background: Globally, cervical cancer continues to be one of the most common cancer among females. The majority of new cases and deaths (approximately 85% and 90%, respectively) occur in low- resource regions or among people from socioeconomically weaker sections of society. The very wide difference in the burden of cervical cancer between high income and low-income countries has been attributed to the successful execution of well-planned, dedicated, and effective screening programs for cervical cancer in high-income countries. The level of screening in general and its integration to routine antenatal care in particular is very low in our country.
Objective: The objective of the study was to assess the level of knowledge, attitude, and practice regarding cervical cancer and its screening and the associated factors among pregnant women attending antenatal clinic in SPHMMC.
Methodology: This was a hospital-based cross-sectional study conducted among pregnant women attending Saint Paul’s Hospital Millennium Medical College ANC clinic from April 1 to June 30 2020. Sample size is calculated for knowledge, attitude and practice using single population proportion formula. Bivariate and multivariable logistic regression analysis were done to see association between predictors and outcome.
Results: The overall level of knowledge among the 304 participants, was good in 166 (54.6%) of them; whereas, 138(45.4%) of the respondents had a low level of awareness. Among the risk factors having multiple sexual partners was identified by 124(23%) of the participants. However, 121(22.5%) of the study subjects didn’t know at least one risk factor from the options given. Out of the respondents, 33.2% of them know that cervical cancer is caused by a virus. Whereas, 48.4% of the study subjects don’t know about the cause and 18.4% of the participants didn’t believe that it is caused by an HPV virus. With respect to attitude towards screening, 156(51.3%) of the participants had a favorable perspective and 148(48.7%) of them had unfavorable stand. In relation to practice of cervical cancer screening, out of the 304 participants 30(9.9%) were screened and the other 274(90.1%) were not screened. In addition, those participants having an income of more than 5,000 birr were 5.2 times more likely to be screened (AOR=5.2, 95% CI (1.5-18)) and participants with no formal education (AOR=0.062, 95% CI (0.05-O.758)) and level only up to primary education (AOR=0.1, 95% CI (0.02-0.63)) were sixteen and ten times less likely to be screened respectively. In contrary to this the degree of attitude didn’t affect extent of practice and participants with good knowledge were found to lower odds of cervical cancer screening practice6 than those with poor awareness((AOR=0.149, 95% CI (0.08-0.218)).
Conclusion and recommendation: In our study the level of knowledge was relatively low compared to the expected but that of attitude was comparable to other similar studies. Optimistically, the study has found that practice of cervical cancer screening was better than other comparable studies. So awareness creation and the incorporation of cervical cancer screening and counselling to the routine ANC is very mandatory and helpful in shifting the balance towards achieving the national as well as international target of elimination of cervical cancer. The other crucial finding is that being knowledgeable and having an optimistic attitude is not sufficient to guarantee that this will be expressed with good practice. So to solve this challenge extra measures of awareness creation and service providing facilities should be sought and established.